Using a smartwatch to identify the morphology of atrial flutter

Ahmed, Asim S.; Golden, Keith M.; Foreman, Jason; Padanilam, Benzy J.

doi:10.1016/j.hrcr.2020.06.021

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…The standard ECG recording obtained with wrist devices is equivalent to ECG Lead I which is sub-optimal for the detection of P-waves and flutter waves. Atypical recording configurations could provide additional lead tracings more suitable for certain arrhythmias ( 6 , 54 ). However, from the user point of view taking Lead I ECG between the arms is easy and thus practical.…”

Section: Discussionmentioning

confidence: 99%

Wrist-worn device combining PPG and ECG can be reliably used for atrial fibrillation detection in an outpatient setting

Saarinen

Joutsen

Korpi

et al. 2023

Front. Cardiovasc. Med.

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AimsThe aim was to validate the performance of a monitoring system consisting of a wrist-worn device and a data management cloud service intended to be used by medical professionals in detecting atrial fibrillation (AF).MethodsThirty adult patients diagnosed with AF alone or AF with concomitant flutter were recruited. Continuous photoplethysmogram (PPG) and intermittent 30 s Lead I electrocardiogram (ECG) recordings were collected over 48 h. The ECG was measured four times a day at prescheduled times, when notified due to irregular rhythm detected by PPG, and when self-initiated based on symptoms. Three-channel Holter ECG was used as the reference.ResultsThe subjects recorded a total of 1,415 h of continuous PPG data and 3.8 h of intermittent ECG data over the study period. The PPG data were analyzed by the system’s algorithm in 5-min segments. The segments containing adequate amounts, at least ~30 s, of adequate quality PPG data for rhythm assessment algorithm, were included. After rejecting 46% of the 5-min segments, the remaining data were compared with annotated Holter ECG yielding AF detection sensitivity and specificity of 95.6 and 99.2%, respectively. The ECG analysis algorithm labeled 10% of the 30-s ECG records as inadequate quality and these were excluded from the analysis. The ECG AF detection sensitivity and specificity were 97.7 and 89.8%, respectively. The usability of the system was found to be good by both the study subjects and the participating cardiologists.ConclusionThe system comprising of a wrist device and a data management service was validated to be suitable for use in patient monitoring and in the detection of AF in an ambulatory setting.Clinical Trial Registration: ClinicalTrials.gov/, NCT05008601.

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Section: Discussionmentioning

confidence: 99%

Wrist-worn device combining PPG and ECG can be reliably used for atrial fibrillation detection in an outpatient setting

Saarinen

Joutsen

Korpi

et al. 2023

Front. Cardiovasc. Med.

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“…Use of consumer-grade wearable rhythm devices and implantable looper recorders is increasingly prevalent, and these single-channel ECG recording devices are subject to unique recording artifacts that can lead to misdiagnoses of arrhythmias. [1][2][3] In both cases, low QRS amplitude in the particular recording vector is mistaken for P waves when associated with frequent PVCs. Although the cause of the artifact is the same, the unique hardware and software configurations of each device require a tailored approach to resolving the problem.…”

Section: Discussionmentioning

confidence: 99%

“…As a result of these inherent limitations, obtaining recordings in additional lead configurations from the Apple Watch by placing the ventral electrode on the left leg or precordium instead of the left wrist (Figure 5) can be helpful in differentiating questionable rhythm findings. 2 The LINQ resides within parasternal subcutaneous tissue and samples at 256 Hz using 2 electrodes on the device body. Poor electrode contact presenting as asystole has previously been reported.…”

Section: Discussionmentioning

confidence: 99%

Challenges of Interpreting Smartwatch and Implantable Loop Recorder Tracings

2021

Self Cite

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“…Although we are not the first group who reported the utility and description of this technique, our study has confirmed its validity in a relatively large sample. Our previous understanding regarding the smartwatch ECGs were limited to the findings of several case reports and case series [ 7 , 27 , 28 , 29 , 30 ], and three studies on around 50–100 patients [ 13 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Reliability of SmartWatch to Obtain 3-Lead Electrocardiogram Recordings

Behzadi

Shamloo

Mouratis

et al. 2020

Sensors

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Some of the recently released smartwatch products feature a single-lead electrocardiogram (ECG) recording capability. The reliability of obtaining 3-lead ECG with smartwatches is yet to be confirmed in a large study. This study aimed to assess the feasibility and reliability of smartwatch to obtain 3-lead ECG recordings, the classical Einthoven ECG leads I-III compared to standard ECG. To record lead I, the watch was worn on the left wrist and the right index finger was placed on the digital crown for 30 s. For lead II, the watch was placed on the lower abdomen and the right index finger was placed on the digital crown for 30 s. For lead III, the same process was repeated with the left index finger. Spearman correlation and Bland-Altman tests were used for data analysis. A total of 300 smartwatch ECG tracings were successfully obtained. ECG waves’ characteristics of all three leads obtained from the smartwatch had a similar duration, amplitude, and polarity compared to standard ECG. The results of this study suggested that the examined smartwatch (Apple Watch Series 4) could obtain 3-lead ECG tracings, including Einthoven leads I, II, and III by placing the smartwatch on the described positions.

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Using a smartwatch to identify the morphology of atrial flutter

Cited by 8 publications

References 5 publications

Wrist-worn device combining PPG and ECG can be reliably used for atrial fibrillation detection in an outpatient setting

Wrist-worn device combining PPG and ECG can be reliably used for atrial fibrillation detection in an outpatient setting

Challenges of Interpreting Smartwatch and Implantable Loop Recorder Tracings

Feasibility and Reliability of SmartWatch to Obtain 3-Lead Electrocardiogram Recordings

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